Total Knee Replacement: What to Expect and How It Works

A total knee replacement can restore your mobility and relieve pain when arthritis or joint damage becomes too severe. Dr. Todd Pitts breaks down common misconceptions, explains how the procedure works, and walks you through what to expect—before, during, and after surgery.

What Is a Total Knee Replacement?

A total knee replacement is a procedure that replaces the damaged cartilage at the ends of the bones in your knee joint with smooth, artificial components made of metal and plastic. Contrary to popular belief, we don’t remove the entire knee—we simply trim small sections of bone and replace the surfaces that are causing pain and inflammation.

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  • Knee arthritis—especially osteoarthritis—develops when the cartilage that cushions your joint wears away. This can happen due to:

    • Genetics

    • Overuse or impact injuries

    • Excess body weight

    • Age-related degeneration

    Once non-surgical treatments like injections, therapy, and bracing no longer work, joint replacement becomes the best option for long-term relief.

  • Using precise measurements and imaging, Dr. Pitts:

    1. Trims the damaged cartilage from the femur and tibia.

    2. Preserves all major ligaments, except the ACL (which is safely removed).

    3. Secures implants to the ends of the bones—metal on top, plastic liner in between.

    4. Restores joint alignment and stability so the knee moves like it used to.

    The procedure typically takes less than two hours, and most patients begin walking the same day.

    • Same-day discharge for most patients

    • Walking and knee bending immediately with physical therapy support

    • No cast or brace required

    • Healing focuses on the soft tissue approach used during surgery

    • Full recovery typically occurs over several weeks, with improved strength and reduced pain as early as 4–6 weeks

  • If your knee pain is interfering with your daily life, sleep, or ability to stay active—and you’ve tried conservative treatments—it may be time to explore a knee replacement. Dr. Pitts is here to help you weigh your options and find the best path forward.